Physicians overwhelmingly endorse single-payer insurance

Nearly two-thirds (64 percent) of Massachusetts physicians favor single-payer national health insurance, far more than support managed care (10 percent) or fee-for-service care (26 percent), according to a Harvard Medical School study published Monday (Feb. 9) in the Archives of Internal Medicine. National health insurance (NHI) received majority support from physicians of virtually every age, gender, and medical specialty – even among surgeons a plurality supported NHI. The breadth of physician support for NHI was highlighted by the fact that most members of the American Medical Association (AMA) and the Massachusetts Medical Society favor the single-payer approach. Despite this high level of support, however, only about half (51.9 percent) of physicians studied were aware that a majority of their fellow physicians support NHI.

The researchers surveyed a random sample of 904 Massachusetts physicians drawn from the AMA’s master file of all doctors. The survey included questions about views on health care financing and medical practice issues. Eighty-nine percent believed that it is the responsibility of society, through its government, to provide everyone with good medical care, regardless of their ability to pay. Physicians also favored physician payment under a salary system (56.8 percent), and would be willing to accept a reduction in fees for a reduction in paperwork (67.1 percent). Doctors overwhelmingly (70.3 percent) rejected allowing the insurance industry to continue playing a major role in the delivery of medical care.

“The perception that physicians oppose national health insurance often serves to reinforce political barriers to health care reform. Our finding that a large majority of physicians actually support single-payer national health insurance could provide the impetus for national health insurance, particularly if physicians began to publicly advocate for their views,” said Danny McCormick, a study author and researcher at Harvard Medical School and Cambridge Hospital (a member of the Cambridge Health Alliance).

David Bor, a study co-author who is an associate professor of medicine at Harvard Medical School and chair of the Department of Medicine at Cambridge Hospital, commented, “At first I was surprised at our results. But when I reflected on my own clinical experience with publicly funded programs like Medicare, I realized that I and many other doctors are convinced that the government can do an excellent job administering health insurance. The plain fact is Medicare works better for patients – and for doctors – than most private insurance plans.”

Steffie Woolhandler, another study co-author and associate professor of medicine at Harvard Medical School and Cambridge Hospital, said, “Most doctors are fed up with the health care system. It’s not just the paperwork and insurance hassles, but knowing that many of our patients can’t afford to fill the prescriptions we write for them. And millions of people who are uninsured avoid care altogether until they’re desperately ill. That’s why more than 10,000 physicians have endorsed a proposal for national health insurance that appeared in the JAMA last August. This survey shows that the overwhelming majority of doctors now support NHI.”